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PRINTED: 07/12/2021 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:HOUSE OF BLESSINGS FAMILY CARE

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The printed 0429 form is a specific tax form used for reporting certain financial information to the relevant tax authority.

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Individuals or entities that meet specific criteria set by the tax authority must file the printed 0429 form, typically those with certain types of income or financial activity.

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